00133 Chronic Pain

Domain 12: comfort
Class 1: physical comfort
Diagnostic Code: 00133
Nanda label: chronic pain
Diagnostic focus: pain
Approved 1986 • Revised 1996, 2013, 2017 • Level of evidence 2.1

NANDA Nursing Diagnosis Definition

Nanda nursing diagnosis « chronic pain ” is defined as: unpleasant sensitive and emotional experience caused by a real or potential tissue lesion, or described in such terms (International Association for the Study of Pain ); Sudden or slow start of any intensity from slight to severe without an early or predictable end, with a duration of more than 3 months.

Definite characteristics

  • Alteration of the ability to continue with activities
  • Anorexia
  • Evidence of pain when using a standardized verification list of pain in those that cannot be communicated verbally
  • Express fatigue
  • Facial expression of pain
  • Reports of nearby people about changes in activity
  • Reports of nearby people about pain behavior
  • Express alteration of the sleep-vigilia cycle
  • Informs intensity using standardized scales of pain assessment
  • Informs pain characteristics using a standardized pain assessment instrument
  • Attention centered on self

Related factors

  • Body mass index above the normal range according to age and sex
  • Fatigue
  • ineffective sexuality pattern
  • harmful agent
  • Malnutrition
  • Prolonged use of the computer
  • Psychological discomfort
  • Repeated handling of heavy loads
  • Social isolation
  • Vibration of the whole body

Risk population

  • People> 50 years of age
  • People with a history of abuse
  • People with a history of genital mutilation
  • People with a history of over-indebtedness
  • People with a history of static positions at work
  • People with a history of inappropriate use of substances
  • People with vigorous exercise history
  • Women

Associated problems

  • Bone fractures
  • Sensitization of the central nervous system
  • Chronic musculoskeletal diseases
  • Contusion
  • Crushing syndrome
  • Image of neurotransmitters, neuromodulators and receptors
  • Immune system diseases
  • Metabolism deterioration
  • Congenital genetic diseases
  • Ischemia
  • Neoplasms
  • Nervous compression syndromes
  • Nervous system diseases
  • Post -traumatism related condition
  • Prolonged increase in cortisol level
  • Soft tissue injury
  • Spinal cord injuries

Suggestions of use

  • See the suggestions of Use for acute pain,

Suggested alternative diagnostics

  • Comfort, deterioration of
  • Acute pain

NOC Results

  • Pain control: personal actions to control pain
  • Pain: harmful effects: severity of the observed or reported harmful effects of chronic pain in everyday actions
  • Pain: Adverse psychological response: Severity of adverse cognitive and emotional responses, observed or reported to physical pain
  • Pain level: gravity of pain observed or referred
  • Patient satisfaction: pain management: degree of positive perception of nursing care to relieve pain

Evaluation objectives and criteria

  • Demonstrates pain: harmful effects, as manifested by the following indicators (specify from 1 to 5: severe, substantial, moderate, light or none):
    • Deterioration in the performance of the role or alteration in interpersonal relationships
    • Concentration deterioration
    • Inability to perform self -care
    • Sleep interruption
    • Loss of appetite
  • Demonstrates pain level, as manifested by the following indicators (specify from 1 to 5: severe, substantial, moderate, light or none):
    • Facial expressions of pain
    • concern, or walk nervously
    • Muscle voltage
    • Loss of appetite
    • Duration of pain episodes
  • Other examples

    The patient will be able to:

    • Verbally express knowledge about alternative measures to relieve pain
    • Indicate that the pain level remains in (specify) or less than (on a scale of 0 to 10)
    • remain productive at work or school
    • Manifest that you enjoy recreational activities
    • Report physical and psychological well -being
    • Recognize the factors that increase pain and adopt preventive measures
    • Use analgesic and non -analgesic measures properly

    NIC Interventions

    • Administration of analgesics: use of pharmacological agents to reduce or eliminate pain
    • Patient controlled analgesia support (ACP): Facilitation of patient control over the administration and regulation of analgesics
    • Facilitation of self -responsibility: impulse to the patient to assume greater responsibility for their own behavior
    • Medication management: facilitation of safe and effective use of drugs with and without recipe
    • Pain management: elimination or reduction of pain until an acceptable level of well -being for the patient
    • mood management: provision of safety, stability, recovery and maintenance to a patient who experiences a depressed or abnormally elevated mood
    • Improvement of coping: Help the patient to adapt to stressful factors, changes or perceived threats that interfere with the satisfaction of the demands and the roles of life
    • Behavior modification: favoring a behavior change

    Nursing Activities

    • See also nursing activities for the diagnosis of acute pain.

    Valuations

    • Value and document the effects of prolonged use of medications
    • (NIC) Pain management.
      • Monitor patient satisfaction with pain management at specific intervals
      • Determine the effect of pain on the quality of life (for example, sleep, appetite, activity, cognition, mood, relationships, labor performance and responsibilities of the role)

    Patient and family education

    • Communicate to the patient that perhaps the complete elimination of pain is not possible

    Collaboration activities

    • Organize a multidisciplinary meeting to plan patient care
    • (NIC) Pain management. Consider channeling the patient, family members and nearby people, support groups and other resources, as required

    Others

    • Offer the patient pain relief measures to complement analgesics (for example, bioretro -food, relaxation techniques, back massages)
    • Help the patient identify a reasonable and acceptable pain level
    • (NIC) Pain management.
      • Promote adequate rest and sleep to facilitate pain relief
      • Medize the patient before an activity to increase their participation, but evaluate the risks of sedation

    At home

    • See the recommendations for the home, of the diagnosis of acute pain.

    Older people

    • See the recommendations for the elderly, of the diagnosis of acute pain